Caregiver Guide: Diarrhea | HealthInAging.org

Understanding the Problem

Diarrhea is the passing of three or more loose or watery stools per day, or a definite decrease in consistency and increase in frequency of bowel movements based upon what is usual for the individual. (Simply put, diarrhea is when a person goes to the bathroom more often than usual for that person and the stool is not as firm as usual.) It is a common problem that usually lasts a day or two and goes away on its own without any special treatment. Diarrhea that lasts more than three weeks can be a sign of a serious problem, or may be due to a less serious condition such as irritable bowel syndrome.

Diarrhea can cause dehydration, which means the body doesn’t have enough fluid to function properly. Dehydration is particularly dangerous in older people, and it must be treated promptly to avoid serious health problems.

People of all ages can get diarrhea. The average adult has an episode of diarrhea about four times a year.

Symptoms of diarrhea

Diarrhea may be accompanied by cramping abdominal pain, bloating, nausea, and an urgent need to use the bathroom. Depending on the cause of the diarrhea, a person might have a fever or bloody stools.

Diarrhea can be either acute or chronic. The acute form, which lasts less than three weeks, is usually related to a bacterial, viral, or parasitic infection.

Chronic diarrhea lasts more than three weeks and is usually related to other problems like irritable bowel syndrome (characterized by recurring abdominal pain associated with a change in consistency and frequency of stools) or diseases like celiac disease (characterized by malabsorption and intolerance to gluten, the protein in wheat) or inflammatory bowel disease (characterized by bloody diarrhea and abdominal pain).

Causes of diarrhea

A few of the more common causes of diarrhea include the following:

Bacterial and viral infections

Certain types of infections can impact our gut, causing us to pass watery stool.

Food intolerance

Some people are unable to digest a component of food, such as lactose (the sugar found in milk) or gluten (the protein found in wheat), which results in celiac disease. In addition, the artificial sweeteners sorbitol and mannitol found in chewing gum and other sugar-free products can cause diarrhea.

Medicine

Diarrhea can be a side effect of many medicines, particularly antibiotics. Antibiotics can disturb the natural balance of bacteria in the intestines.

Other causes

• Intestinal diseases such as inflammatory bowel disease or celiac disease.
• Functional and other bowel disorders such as irritable bowel syndrome, or the result of stomach surgery, or removal of the gallbladder.
• People who visit foreign countries are at risk for traveler’s diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites.
• In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.

Your goals are to:

• Call for professional help when needed
• Replace lost fluids and nutrients
• Consider diarrhea medicines
• Avoid offering certain foods while there is diarrhea
• Do what you can to increase the older person’s comfort

Click on each of the topics below to read more.

Diarrhea | Rodale Wire

In the past when someone had diarrhea, doctors whipped out their prescription pads and dispensed antidiarrheal medication. Today, they think the best medicine is to simply let diarrhea run its course, if you’ll pardon the pun. “Acute diarrhea is one of your body’s best defense mechanisms,” says Lynn V. McFarland, PhD. “It’s your body’s way of getting something nasty out of your system.” That thought may or may not be of comfort to you right now, but it explains why doctors today tell you to “tough it out” instead of automatically trying to stem the tide of this annoying, but hopefully short-lived, illness.

MORE: How To Stop Diarrhea

“I don’t recommend antidiarrheal medications when a patient has acute diarrhea unless he has an urgent need for control—like a very important business meeting that just can’t be missed,” says David A. Lieberman, MD. “Otherwise, I think the purge is probably beneficial and helps speed recovery,” he says.

Heeding that approach, most of the tips that follow are designed to help you weather the discomfort of diarrhea and make a quick recovery, rather than trying to halt the course of diarrhea and risk prolonging the illness. For those who may have “an urgent need for control” while stricken, we’ve listed some medications to help stem the tide while you take care of other business.

Make The Milk Connection

A leading cause of diarrhea in this country is lactose intolerance, says William Y. Chey, MD. “Lactose intolerance can have its onset when you’re just a baby, or it can kick in suddenly during your adult years,” says Chey. One day you could be drinking milk, and the next thing you know—bam!—you have gas, pain, and diarrhea. The cure, of course, is to avoid lactose-containing foods, which means staying away from most dairy products, with the exception of yogurt, some aged cheeses such as cheddar, and those cheeses specifically designed to be lactose-free, such as Lactaid.

MORE: 10 Dairy-Free Ways To Get Calcium

Take The Tolerance Test

Given the dose-related nature of lactose intolerance, as well as its ability to kick in unexpectedly, how can you be sure that milk products are responsible for your tummy troubles? First, completely abstain from milk and other dairy products for a week or two and see if that helps, says Lieberman. If it does, gradually add back dairy products with the knowledge that you may hit an intolerance point and the symptoms will return. Once you know what that point is, you can avoid lactose-induced diarrhea by eating fewer dairy products.

Think About Your Medications

Our experts say there’s a good possibility that the diarrhea you have now was caused by the heartburn you had earlier today. It’s not because of a direct connection between stomach and bowel, but because of the antacid you may have taken to soothe your burning belly. “Antacids are the most common cause of drug-related diarrhea,” says Harris Clearfield, MD. “Maalox and Mylanta both have magnesium hydroxide in them that acts exactly like milk of magnesia, which makes these antacids a common cause of diarrhea.” To avoid future bouts of heartburn-related diarrhea, he suggests trying antacids that contain aluminum hydroxide, with no magnesium added, such as Gaviscon or Alterna­Gel. “These are less likely to cause diarrhea,” Clearfield says, “but they’re less effective, too.”

MORE: 9 Foods That Soothe Heartburn Naturally

Some antibiotics, quinidine, lactulose, and colchicine may also cause diarrhea. Consult your doctor if you suspect that these or any other medications may be causing problems for you. Large doses of vitamin C can be a culprit behind diarrhea, too. Amounts over the Daily Value (60 milligrams) may cause diarrhea in some people, but most are fine with up to 2,000 milligrams per day as long as they divide their doses over the course of the day.

Eat Lightly

“The less food that your system has to process, the fewer symptoms of cramping and diarrhea you will experience,” says Sheila Crowe, MD. But if you’re hungry, eat bland, light foods such as toast, cooked rice, or bananas.

Consume A Clear Diet

“Start with a clear-liquid diet,” says Chey. “By ‘clear’ I mean chicken broth, Jell-O, or other foods and fluids you can look ‘clear’ through.” This helps your bowel to rest during the diarrhea, rather than forcing your system to handle more than it really should have to. After you’ve tested the waters with broth and Jell-O, you can gradually introduce rice, bananas, applesauce, and yogurt into your diet as your symptoms improve.

Cut Back On Meat

“Fatty foods are hard to digest and may often lead to diarrhea,” says Barbara Frank, MD. So avoid high-fat snacks, and eat lean meat and nonfat dairy products, not full-fat versions. (Here’s 6 things that happen when you stop eating meat.)

Keep Liquid Levels High

“The type of food you eat doesn’t really matter as much as drinking enough,” says McFarland. “The most serious thing is to make sure your fluid intake is high.” Though many folks don’t feel like consuming large amounts of liquids during bouts of diarrhea, all our experts agree that increasing your fluid intake is vital to ward off dehydration. Fluids that contain salt and small amounts of sugar are particularly beneficial, because they help the body replace glucose and minerals lost during diarrhea. A good “rehydration fluid” can easily be made by adding 1 teaspoon of sugar and a pinch of salt to 1 quart of water. A more complex but tastier mix can be made by adding 1/2 teaspoon of honey or corn syrup and a pinch of table salt to 8 ounces of fruit juice. Stir well and drink often. Or just buy Gatorade. It contains glucose and electrolytes in sufficient quantities to replace those your body is losing.

MORE: 25 Flat Belly Sassy Water Recipes

Avoid These Foods

While eating may not be as important as drinking for riding out diarrhea, some foods should be avoided. Obvious ones to pass up include beans, cabbage, and brussels sprouts. Other foods containing large amounts of poorly absorbed carbohydrates can aggravate diarrhea. A short list includes bread, pasta, and other wheat products; apples, pears, peaches, and prunes; corn, oats, potatoes, and processed bran. And, just in case you were reaching for that carton of ice cream, all our experts say that you should avoid dairy products (with the exception of yogurt) during a bout of diarrhea. Even if milk products didn’t trigger diarrhea, they tend to aggravate diarrhea after you have it. (Here’s what happens when you stop eating dairy entirely.)

Stay Away From Artificial Sweeteners

Sorbitol, an artificial sweetener found in sugarless gum and mints and in many diet sodas often leads to the runs, because it’s not easily digested, says Ann Ouyang, MD.

Avoid Soft Drinks

“I’d suggest avoiding carbonated beverages as well,” cautions Clearfield. “The gas they contain may add additional explosiveness to a delicate situation.”

MORE: How To Break Your Diet Soda Addiction In One Week

Stay Out Of The Kitchen

While we’re still on the subject of food, you or any member of your family with diarrhea should not prepare food for other members of the household until the diarrhea subsides. Also, good hand-washing helps keep a parasitic infection from spreading. (If your job involves contact with large numbers of people or food handling, state law may require that you stay off the job until all symptoms subside.)

If You Must, Take Something To Stem The Tide

Our experts insist that letting diarrhea “run its course” is the best medicine going. If, however, you absolutely must go someplace and be in control while you’re there, the over-the-counter product Imodium, which is available in capsule or liquid form, is probably your best bet for slowing down the flow. “Imodium is very effective,” says Clearfield. “It works by causing the bowel to tighten up, and by doing so, prevents things from moving along.” But Imodium isn’t your one and only choice. Hydrophilic (hydro means water, and phili means love) products, such as Kaopectate and Pepto-Bismol, may also help treat mild diarrhea.

Try Some Tea

Tea is rich in tannins, which help bind stools and hold back bowel movements. Evangeline Lausier, MD, suggests drinking a cup of chamomile tea. The herb has an antispasmodic effect that stops contractions in the lower intestine.

Consider Honey

“Stir some honey into your iced or green tea and get double the health benefits—in the honey and in the tea,” says Janet Maccaro, PhD, CNC. “I try to steer people away from artificial sweeteners, and honey is a wonderful healthful alternative,” she says. “Honey contains all the vitamins and minerals necessary for proper metabolism and the digestion of glucose and other sugars. It’s a natural sweetener with antibiotic and antiseptic properties.” Maccaro recommends using from a teaspoon to a tablespoon in a cup of hot tea or glass of iced tea, depending on your preferred level of sweetness. Not a tea drinker? Drizzle a tablespoon of honey over some fresh fruit for a tasty treat, she says.

MORE: 20 Clever Uses For Honey In And Out Of The Kitchen

Calm And Soothe

When diarrhea strikes his family, Gannady Raskin, MD, ND, cures it with herbal concoctions. “Tea made from pomegranate skin will help an upset stomach,” he says. Set aside the leftovers of your next purchase; you can store dried pomegranate skin for up to 6 months. Steep a tablespoon’s worth in a cup of boiling water for 3 to 4 minutes. Oak bark (available at health food stores) works, too: Boil for 3 minutes, let sit for half an hour, and then strain. Both recipes are rich in tannins, which help the body produce mucus to line the stomach and lessen irritation. Drink 2 tablespoons, four to six times a day.

Traveler’s Diarrhea: The Globetrotter’s Curse

Montezuma’s revenge, Delhi belly, Tiki trots. Whatever you call it, traveler’s diarrhea—the official name is turista—can dampen one’s spirits on even the best of vacations. “If you’re going to be abroad for any length of time, you’ll probably have some episodes of diarrhea,” says Stephen Bezruchka, MD, a frequent traveler. “Conceptually, it is totally preventable. In reality, it’s rare if you don’t get an occasional loose movement. ”

In fact, you have a 50% chance of getting turista, even if you take the recommended precautions. The most common cause is the Escherichia coli bacteria. This widespread little organism normally resides in your intestines and performs a role in digestion. But foreign versions of E. coli —and to a foreigner, the American version is foreign—can give you diarrhea by producing a toxin that prevents your intestines from absorbing the water you ingest in the form of fluid and food. As the toxin prevents the absorption of water, you have all this extra water in there, and it’s got to come out, Bezruchka says. “The toxin doesn’t get absorbed. You don’t usually feel sick, but you might feel you have to pass some gas. Only it isn’t gas at all.”

Shigella and salmonella bacteria can also produce turista, while a smaller number of cases are caused by rotavirus and the giardia parasite. Changes in diet, fatigue, jet lag, and altitude sickness have been blamed but without sufficient proof, and up to 50% of all turista cases are unexplained. Luckily, there are ways to help your body fight turista. Here’s what doctors suggest: 

• Drink water, water anywhere. When you have turista, your stools are mostly water. So why would the most important treatment be to drink plenty of the right fluids? Because dehydration, the loss of water and electrolytes, can kill. “A lot of what you take in will be pumped right back out the other end,” concedes Thomas Gossel, PhD, RPh. “But you’ll reach a point where you stabilize and begin retaining it. If you didn’t replace any fluids at all, you could become dehydrated in a day.”
• Put your bladder to the test. The yellower your urine, the more fluid you need. It should be clear or pale yellow. Use a rehydration solution. An even better way to rehydrate is to drink an ORS, also known as an over-the-counter rehydration solution. These drinks contain sugar and salt and help replace important electrolytes that are lost through diarrhea. They also help your intestines absorb water better. Over-the-counter rehydration solutions are readily available in the United States, so you can buy and take them with you. Brands include ReVital and Pedialyte. Choose a backup beverage. If you didn’t manage to pack an ORS, drink clear fruit juices or weak tea with sugar.
• Get in the pink. Pepto-Bismol, the well-known over-the-counter stomach medication, can be the traveler’s friend. It makes stools bulkier and firmer, and it kills bacteria. Don’t worry if your tongue and diarrhea turn black. It’s a natural side effect of Pepto-Bismol.
• Wine a little. No Pepto in sight? Knock back a glass of wine (red or white). One study found it worked as well or better than the pink stuff. The alcohol’s antibacterial properties killed off bacteria that cause traveler’s diarrhea within 20 to 30 minutes. But no need to overindulge—one glass is probably enough. Researchers estimate that 6 ounces of wine is all it takes to get the benefits.
• Do a little coaxing. Natural fiber-based laxatives for relieving constipation, such as Metamucil and Citrucel, also help with diarrhea. Some can absorb up to 60 times their weight in water to form a gel in the intestine. “You’re still going to expel excess water,” Gossel says, “but it won’t be so runny.” Other brands are Equalactin, FiberCon, and Konsyl.

Of course, it’s best not to have to worry about traveler’s diarrhea in the first place. Here’s how to protect yourself: 

• Avoid uncooked vegetables, especially salads, fruits you can’t peel, undercooked meat, raw shellfish, ice cubes, and drinks made from impure water (the alcohol in drinks won’t kill the turista bug).
• Ask if the dishes and silverware you use have been cleaned in purified water.
• Drink only water that’s been carbonated and sealed in bottles or cans. Clean the part of the container that touches your mouth with purified water. Boiling water for 3 to 5 minutes purifies it, as does adding iodine liquid or tablets.
• Drink acidic drinks like colas and orange juice when possible. They help keep down the E. coli count, the bacteria most responsible for digestive distress.
• Drink acidophilus milk or eat yogurt before your trip. The bacterial colonies established in your digestive system before your trip and maintained during it will help you reduce the chance of a turista invasion.

Do You Need To Call A Doctor For Your Diarrhea?

Diarrhea should normally leave you only slightly worse for wear. In infants, small children, elderly people, or those already sick or dehydrated from another illness, however, acute diarrhea can be particularly severe and demands prompt medical attention. Medical help is also needed if diarrhea doesn’t subside in 1 to 2 days, if it’s accompanied by fever and severe abdominal cramps, or if it occurs with rashes, jaundice (yellowing of the skin and whites of the eyes), or extreme weakness.

If there’s blood, pus, or mucus in your stools, call your doctor. “The most immediate risk associated with acute diarrhea is dehydration,” says Clearfield. “If an individual is having a major bout of diarrhea and isn’t taking in any food or drink during that time, you’re looking at a medical emergency.”

Panel Of Advisors

Stephen Bezruchka, MD, is a senior lecturer in the School of Public Health and Community Medicine at the University of Washington in Seattle.

William Y. Chey, MD, is director of the Rochester Institute for Digestive Diseases and Sciences and a physician in Rochester, New York. He holds positions of professorship at numerous universities in China and Korea, and is a fellow of the American Gastroenterological Association.

Harris Clearfield, MD, is a professor in the department of medicine at Drexel University College of Medicine and section chief in the department of gastroenterology at Hahnemann University Hospital, both in Philadelphia.

Sheila Crowe, MD, is a professor of medicine in the division of gastroenterology and hepatology in the Digestive Health Center of Excellence at the University of Virginia in Charlottesville.

Barbara Frank, MD, is a clinical professor of medicine in the division of gastroenterology and hepatology at Drexel University College of Medicine in Philadelphia.

Thomas Gossel, PhD, RPH, is former dean of the College of Pharmacy at Ohio Northern University in ADA.

Evangeline Lausier, MD, is a clinical assistant professor of medicine at Duke Integrative Medicine in Durham, North Carolina.

David A. Lieberman, MD, is head of the division of gastroenterology at Oregon Health and Science University in Portland.

Janet Maccaro, PhD, CNC, is a holistic nutritionist in central Florida.

Lynn V. McFarland, PhD, is a medicinal chemistry adjunct associate professor and epidemiologist at the University of Washington in Seattle and coauthor of The Power of Probiotics.

Ann Ouyang, MD, is a professor of medicine at Pennsylvania State College of Medicine and former chief of the division of gastroenterology and hepatology at Pennsylvania State University Milton S. Hershey Medical Center in Hershey, Pennsylvania.

Gannady Raskin, MD, ND, is dean of the school of naturopathic medicine at Bastyr University in Seattle.

Drink water and diet BRAT: how to properly treat diarrhea at home

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Irina Nevinnaya

In summer, the risk of intestinal disorders increases: the nature of nutrition changes, we eat more greens and berries, and the digestive system does not always have time to quickly reorganize. But serious infections can also cause diarrhea – salmonellosis, dysentery, rotavirus. The risk of contracting them in the summer also increases. How to protect yourself? And what can be done to stop diarrhea? Daria Ovchinnikova, a gastroenterologist at the Clinic of Ilya Trukhanov (“KIT”), answered these questions to Rossiyskaya Gazeta.

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“Diarrhea has several causes. It can be a rotavirus or bacterial infection, or eating food that has been stored incorrectly or for too long. In addition, diarrhea can occur with an enzyme deficiency that develops as a result of acute or chronic pancreatitis , or while taking antibiotics,” Ovchinnikova explained.

How do you tell a common food poisoning from an intestinal infection?

The nature and frequency of the stool is assessed first. The reaction to an expired product usually resolves within three to six hours. An infection is characterized not only by an increase in the number of “shoots” to the toilet, but also by the appearance of blood in the stool or more mucus. An alarming symptom is a sharp increase in body temperature (more than 38-38.5 degrees).

“If such symptoms persist for more than three days, and if other family members also become ill, this may indicate the presence of a rotavirus infection. In addition, the appearance of blood is always an alarm signal that requires a visit to the doctor and additional examination,” she explained. gastroenterologist.

How to deal with diarrhea at home?

• Drink more water to restore fluid and electrolyte balance.
• Take additional electrolytes (eg Regidron).
• For the first two days, adhere to the BRAT diet – eat mainly bananas, rice, baked apples or applesauce, dried bread (toast, crackers), black tea – such food does not irritate the intestines. This will allow you not to starve and recover faster.
• Starting on day 3, start on a Low FODMAP diet, which involves limiting fermentable carbohydrates that increase fermentation and gas production, such as sauerkraut and sour-milk products. Adhere to this diet should be 7-10 days.
• Do not just use sorbents (activated carbon, enterosgel, polysorb). They are used mainly for poisoning with alcohol, drugs or chemicals to slow down the absorption of a poisonous substance.

“If we talk about medical care, then, depending on the accompanying symptoms, antispasmodics (for example, no-shpa) are used to relieve abdominal pain, carminative drugs (espumizan) – for bloating, antipyretics (paracetamol) – to bring down the temperature (if it exceeds 38-38.5 degrees). Antibiotics should be prescribed by a doctor – they should not be taken on their own. Until diarrhea has passed, it is better to lie down and limit your exits from the house, “advises Dr. Ovchinnikova.

How can I reduce the risk of diarrhea?

• In summer, especially when it is hot, it is worth reducing the shelf life of food – both fresh and cooked. Warm temperatures increase bacteria growth and food spoils faster.
• For dressing salads, it is better to use olive or sunflower oil, rather than mayonnaise or sour cream.
• It should be noted that young children are more susceptible to rotavirus infection – their immunity is not yet strong protection, so they often become infected in crowded places, for example, on vacation, in hotels, in public transport, at playgrounds and during swimming in the pools.

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how to stop diarrhea? Regular intake of BAK-SET will help stop diarrhea after antibiotics and restore a healthy balance of intestinal microflora.. Multi-probiotic BAK-SET

Taking antibacterial drugs is the main component of the treatment of many inflammatory diseases. Unfortunately, these medicines have an aggressive effect and kill not only pathogenic, but also beneficial bacteria. As a result, the natural balance of the intestinal flora is disturbed, so diarrhea after antibiotics is a common occurrence. Let’s find out why diarrhea occurs and how to deal with it.

Causes of diarrhea

Diarrhea after antibiotics is provoked by the following factors:

• too high doses of the drug,
• negative effect of drugs on the intestinal microflora,
• side effects.

Antibacterial drugs stimulate intestinal motility, which causes diarrhea. The frequency of defecation reaches 4 times a day, but the state of health usually does not worsen. Diarrhea lasts from the first day of taking the drugs and disappears after they are discontinued.

Therapeutic diet

To quickly restore the disturbed microflora, patients are advised to follow a diet. At the time of taking antibiotics and within 2-3 days after their cancellation, the following foods should be excluded from the diet:

• preserves, smoked meats and pickles,
• sausages,
• fatty and fried foods,
• seafood and crab sticks,
• ice cream and confectionery,
• milk and dairy products,
• fruits rich in fiber.

When the condition improves, you can include steam cutlets, crumbly cereals, soups on vegetable or weak meat broth in the menu. Bread and flour can be eaten no earlier than 10 days after normalization of the stool.

The role of probiotics in the treatment of diarrhea

Treatment of diarrhea after taking antibiotics includes taking probiotic preparations. They contain live beneficial bacteria in the required amount and effectively restore the balance of intestinal microflora.

All probiotics have different effectiveness. It depends on the composition and compliance with storage conditions. Unlike most preparations, multi-probiotics BAK-SET baby and BAK-SET forte contain a whole complex of beneficial bacteria and do not lose their properties at room temperature. Thanks to the convenient form of release, they are easy to take on the road and take anywhere. The only contraindication is individual intolerance to any of the components.

With regular use of BAK-SET baby and BAK-SET forte restore a healthy balance of intestinal microflora and contribute to the normalization of stool.